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A Journal on Phlebology
Acta Phlebologica 2009 April;10(1):23-31
Hemodynamic patterns of small saphenous vein system incompetente
Riabinska O. S., Volkov D. E., Boyko V. V.
Institute of General and Urgent Surgery AMS of Ukraine, Kharkiv, Ukraine
Aim. The aim of the study is to determine the hemodynamic patterns of small saphenous vein (SSV) system incompetence including sources of reflux, distribution and extent of reflux in SSV system and other superficial veins.
Methods. From patients with clinical manifestation of chronic venous disease (CVD) we selected those with reflux in SSV system. All patients underwent color flow duplex scanning (CFD). Research included limbs with concomitant reflux changes of the great saphenous vein (GSV) and non-saphenous veins and excluded those with valve insufficiency of deep veins, thrombosis of superficial and deep veins, and also patients who underwent surgery or sclerotherapy. A scheme of manifestation of hemodynamic components of the retrograde venous circuit was set up according to the results of the research.
Results. There were 96 patients with reflux in SSV system (101 extremities). According to CEAP classification, 80.1% of limbs were in CVD class 2 and 3 and less than 20% in CVD classes 4-6. Isolated reflux in SPJ, SSV trunk and SSV tributaries was observed only in 14.85% of cases. In 85.15% of limbs reflux changes of the SSV system were combined with the reflux along GSV and its tributaries, or with non saphenous sources of reflux, or reflux was present solely in non saphenous veins.
Conclusion. Schematic presentation of the ways of reflux in the SSV system allows determination of whether they are of primary nature or are a part of axial reflux in case of GSV incompetence or non saphenous veins incompetence.